{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:37:44Z","timestamp":1753889864414,"version":"3.41.2"},"reference-count":0,"publisher":"American Diabetes Association","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100000066","name":"NIEHS","doi-asserted-by":"crossref","award":["R01ES030353"],"award-info":[{"award-number":["R01ES030353"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>We investigated the association between historic redlining and risk of gestational diabetes mellitus (GDM), and whether this relationship is mediated by maternal obesity and area-level deprivation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>This retrospective study included 86,834 singleton pregnancies from Kaiser Permanente Southern California\u2019s health records (2008\u20132018). Redlining was assessed using digitized Home Owners\u2019 Loan Corporation (HOLC) maps, with patients\u2019 residential addresses geocoded and assigned HOLC grades (A, B, C, or D) based on their geographic location within HOLC-graded zones. For GDM case patients, exposure was assigned based on address at diagnosis date; for noncase patients, it was assigned based on address during the 24th to 28th gestational week. Health records were combined with area deprivation index (ADI) from 2011 to 2015 census data. Mixed-effect logistic regression models assessed associations between redlining and GDM, with mediation by BMI and ADI evaluated using inverse odds ratio weighting. Models were adjusted for maternal age, education, race and ethnicity, neighborhood-level income, and smoking status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Among the 10,134 (11.67%) GDM case patients, we found increased risk of GDM in B (\u201cstill desirable,\u201d adjusted odds ratio [aOR] 1.20, 95% CI 0.99\u20131.44), C-graded (\u201cdefinitely declining,\u201d aOR 1.22, 95% CI 1.02\u20131.47), and D-graded (\u201chazardous,\u201d i.e., redlined, aOR 1.30, 95% CI 1.08\u20131.57) neighborhoods compared with the \u201cbest\u201d-graded zone. Prepregnancy BMI and ADI mediated 44.2% and 64.5% of the increased GDM risk among mothers in redlined areas.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Historic redlining is associated with an increased risk of GDM, mediated by maternal obesity and neighborhood deprivation. Future research is needed to explore the complex pathways linking redlining to pregnancy outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc24-2147","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T16:34:26Z","timestamp":1739378066000},"update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Association of Historical Redlining With Gestational Diabetes Mellitus: The Mediating Role of BMI and Area Deprivation Index"],"prefix":"10.2337","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9765-817X","authenticated-orcid":false,"given":"Wajeeha","family":"Umer","sequence":"first","affiliation":[{"name":"1Department of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Sun","sequence":"additional","affiliation":[{"name":"1Department of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA"},{"name":"2Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anqi","family":"Jiao","sequence":"additional","affiliation":[{"name":"1Department of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen D.","family":"Lincoln","sequence":"additional","affiliation":[{"name":"1Department of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengyi","family":"Li","sequence":"additional","affiliation":[{"name":"1Department of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal C.","family":"Avila","sequence":"additional","affiliation":[{"name":"3Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicki Y.","family":"Chiu","sequence":"additional","affiliation":[{"name":"3Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeff M.","family":"Slezak","sequence":"additional","affiliation":[{"name":"3Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Sacks","sequence":"additional","affiliation":[{"name":"3Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA"},{"name":"4Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Molitor","sequence":"additional","affiliation":[{"name":"5College of Public Health and Human Sciences, Oregon State University, Corvallis, OR"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarik","family":"Benmarhnia","sequence":"additional","affiliation":[{"name":"6Scripps Institution of Oceanography, University of California, San Diego, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiu-Chiuan","family":"Chen","sequence":"additional","affiliation":[{"name":"7Population & Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darios","family":"Getahun","sequence":"additional","affiliation":[{"name":"3Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA"},{"name":"8Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Wu","sequence":"additional","affiliation":[{"name":"1Department of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2025,2,12]]},"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc24-2147\/798575\/dc242147.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc24-2147\/798575\/dc242147.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T16:34:27Z","timestamp":1739378067000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/doi\/10.2337\/dc24-2147\/157868\/Association-of-Historical-Redlining-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,12]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2337\/dc24-2147","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"type":"print","value":"0149-5992"},{"type":"electronic","value":"1935-5548"}],"subject":[],"published":{"date-parts":[[2025,2,12]]},"article-number":"dc242147"}}